Chapter 18
Nora moved through the routines of the clinic the next day, recording pulse rates and tongue color, chest sounds and pupil size. She changed bandages while carrying on short conversations with Julia but remembered none of them. Work pulled her past tea and into the soggy autumn evening.
By eight, gas lamps burned in the surgical theater, the precisely angled mirrors directing the steady light onto a nervous patient with a stiff chin, wrapped tightly in a robe.
Miss Rawly had insisted on waiting until after factory hours for her surgery so she wouldn’t lose additional pay.
Now her eyes riveted on the tumultuous evening sky, visible through the high windows.
Each flash of lightning cutting through the dark made her flinch.
There were reasons why Nora scheduled most surgeries for daytime—other than better light. The hoots of pigeons and ruckus of the busy street outside reassured patients with their mundane normalcy; the patter of rain on a black window and the noise of distant thunder did not.
“I know the table is hard, but you’ll be sleeping soon and won’t notice,” Nora reassured her.
Daniel had agreed days ago to administer the ether for tonight’s procedure.
Though he’d been present at Horace’s lecture last night, they’d each kept to their own sides of the room.
Once Miss Rawly was unconscious, they’d be alone together for the first time since their quarrel.
But for now, he waited outside in the hall.
“We’ll remove the robe, and I’ll inspect the tumor once again before we begin.”
“It doesn’t cause much pain,” Miss Rawly said, her finely lined skin in contrast to her thick sheet of hair, as if her body couldn’t decide whether to remain in youth or sink into age.
“I know,” Nora said, probing the red streaks in her left breast above the tumor. The size of an almond and just as hard. She used a wet charcoal stick to mark lines to guide her cuts. “But it is much safer to remove it now. I’ve treated too many women who never did.”
It was a delicate dance along a spider’s web to convince a patient of the need for treatment without terrifying them. As she settled Miss Rawly onto the table, Nora silently worked ahead, choosing the angle of incision. “I’ll go get the other surgeon now. He’ll be administering the ether.”
The patient’s eyebrows sank in dismay. “Will the other surgeon be doing the cutting?” The hope in her voice did nothing to bolster Nora, who drew in a breath.
It was always worse when women doubted her.
Nora forced a smile. “I’ve done many surgeries. And I’m as careful with my stitches as you are sewing in the factory.”
Miss Rawly supported herself by sewing men’s trousers day in and out. Slightly comforted, her brow loosened.
“She’s ready,” Nora whispered to Daniel through the curtain.
He swept in quietly, arranging the vaporizer on the small table at the woman’s head. He’d tipped a kettle of boiling water into the steel basin to keep the ether warm and the vapors consistent. “This will be much easier than some people say,” Daniel reassured her.
Nora looked away, trying to ignore the petulant flame in her stomach when the woman turned trusting eyes on her husband. Whatever he said, she took as gospel.
Daniel coaxed and explained as he lowered the mask to Miss Rawly’s face.
Nora had to admit his bedside manner was meticulous and authoritative, yet unfailingly soft and cajoling.
She could do the exact same if patients didn’t look at her the way they looked at the floating eyeballs in Horace’s specimen jars.
Miss Rawly never even coughed as the ether overtook her. Daniel increased the fumes so slowly she noticed nothing except the eventual shuttering of her eyes.
“Well done.” Nora couldn’t help but praise.
“Thank you.” So stiffly polite, like nervous colleagues.
Nora probed the lump with her fingers and laid the scalpel to the charcoal line. The skin parted, globules of yellow fat blooming as she drew the blade nearer to the offending tumor—encapsulated in tough, stringy fibers but clearly outlined from the healthy tissue.
“It will take a minute to free it from this web.” She adjusted her head so she wouldn’t block the light.
Before his stroke, Horace would have extracted this tumor before Nora had even breached the subcutaneous tissue.
She never understood his speed. But then, thanks to ether, she’d never operated on a screaming, pleading patient.
For better or worse, ether had slowed down operations considerably.
Daniel left the vaporizer to sponge the wound and hold the retractors for her as she ligated a blood vessel in the way. “I can see the lesion,” she said. “But it’s buried deep.”
“Just keep tying off the blood vessels and working your way down,” he coached. She hated to admit she would rather operate with Daniel than work alone. Was she as bad as her patients—unconsciously seeking reassurance from the presence of a male doctor?
When she finally freed the mass, she drew it out, trying not to worry over the copious flow of blood.
Daniel gave a low whistle. “That’s a large one. It looks like a river rock.”
Nora dropped it into a bowl for later examination as Daniel swiftly sponged and ligated the severed veins. “Look how smooth it is,” he marveled. “The last one I extracted was a mess of tissue.”
“Did the woman survive?” Nora asked.
“Hale and hearty today.” Daniel smiled, almost erasing the past twenty-four hours with one dimple in his chin. “But then, the surgery was only a week ago.”
Nora waited until he’d finished suturing the muscle before she stepped in and brought the lip of the wound together. The scar would be small compared to the tumor she’d coaxed out from the breast. She commenced with straight, careful stitches.
“What’s the news from Bart’s?” she asked as she worked, her shoulders tightening when she realized this might lead back to the petition and the fight against midwives.
Daniel was smarter than that. “Jeffers had the latest Provincial today. Have you read it?”
“Haven’t seen it. I suppose Horace is hoarding it.” Nora leaned closer to her work, carefully maneuvering a stitch so it wouldn’t pucker.
“An article by a Dr. Conway,” Daniel continued as he monitored the vaporizer. “He claimed he’s seen cholera cases in London. He classified the cases as Asiatic.”
Nora’s eyes flitted up. “How many? Where?” Horace had seen the one on the ship, but no other sailor had contracted the terrible blight.
“Only two. Last year Conway reported six, and nothing came of it. Horace says he’s an alarmist.”
Nora’s shoulders rounded with relief. “Two cases doesn’t sound like cholera.
” Though immune to the common fears of corpses and dismembered limbs, if Nora had a monster that haunted her, it was the sallow, yellow cloud that had swept over her childhood like the grim reaper, only to lose its grip on her collar as it bore her family away.
“Horace is going to the club to talk with Conway tonight,” Daniel said, watching her face. “I’m sure it’s an isolated case, like the sailor.”
Nora’s teeth found the inside of her lip. Horace would find out the truth. She’d watched him lure, cajole, flatter, and intimidate his way to information before.
Daniel took Miss Rawly’s pulse. “Pulse fifty-five beats per minute. Respiration slow and deep. Tongue pink. I’m removing the mask.” He glanced over Nora’s work. “What stitch is that?” he mused. “I would have used simple continuous, but yours look stronger.”
Nora didn’t let her warming cheeks show as she dipped her head. “A variation of herringbone.”
“Herringbone?” he asked in confusion.
“Particularly useful in needlepoint for making crosshatches,” she admitted.
Daniel gave a laugh. “No fair having all those womanly arts to draw on.”
If he was being gracious, so could she. She anointed the sutures with wine and olive oil—a practice Horace, Daniel, and Harry had also picked up, more as a good luck talisman than anything else.
Horace was even testing the effect, inflicting sutures on dozens of sedated mice.
I do believe the wine diminishes inflammation, he admitted. The red perhaps better than the white.
But she was stalling. She rubbed her hands together, trying to strike up the flame of courage. With the wound cleaned and Miss Rawly sleeping peacefully and painlessly, there was no better time to tell Daniel what Horace and Mrs. Phipps suspected.
What she herself was beginning to suspect. Her stomach quivered mercilessly. She had no doubts he’d be giddy with joy. But her work—her future as a surgeon—existed in a dark mist her searching eyes couldn’t penetrate.
Her lips parted, words stirring like seeds reaching for the sky, until she recalled Daniel’s face on Friday evening. He’d looked confused, almost appalled, that she’d want to continue working after having children. If he didn’t sympathize with her goals, who would ever be on her side?
Nora surveyed the smooth, hard tumor glistening in the bowl.
She’d made clean work of the removal in less than ten minutes, possibly saving a woman from future torment.
And yet, even with such skill, Mrs. Phipps surely wouldn’t approve of her cutting away with an infant in the nursery.
Daniel’s family would be freshly horrified, though she could accustom herself to their tantrums. Julia adored babies.
She’d be baffled that anyone would put one down in order to take up a scalpel.
Perhaps only Horace would understand. And Magdalena.
Nora blinked, hiding a long second in the darkness.
An eccentric genius and a philandering single woman to back her. That hardly buttressed her argument.
“Are you well?” Daniel asked as she continued her careful stitching. “You’re quiet.”
Nora swallowed. “Just concentrating.”
As soon as she told—if there was even anything to tell—there’d be a hurricane of opinions swirling around her.
She’d be ordered off her feet, away from sick patients, forbidden to attend strenuous births.
But it had been almost four weeks now, and the longer she waited to tell him, the more hurt he’d be.
Nora pulled the sheet up, covering Miss Rawly’s exposed breast. “Let’s hope we got it in time,” she said. “I didn’t see or feel any others.”
Daniel carefully poured the hot water from the vaporizer down the floor drain and buffed away a stray drop from his glossy shoes. “If you didn’t, no one would.”
He glanced at her, relief plain on his face that had nothing to do with the patient.
Nora understood instantly. He’d expected another row—thought she’d demand an explanation and apology for his cowardly act of giving in to Adams. At least, she chose to believe it was temporary cowardice and not a true endorsement.
She knew it well—the fear that kept one from telling the truth.
She wiped down her instruments, replacing them in their leather sleeves as she tried again to construct an opening sentence that stubbornly refused to form in her brain.
Everything in her shouted to delay, at least a little longer.
There were too many patients counting on her.
Ruth and Mrs. Howell were beginning to trust her more, and both had so much to learn.
“Thank you for assisting me today,” she murmured just as Miss Rawly began to stir.
Soon, she silently promised.